Smiling health minister Andrew Lansley puts the knife in the National Health Service. Who needs the Grim Reaper when you’ve got this snowy haired rider of the apocalypse riding roughshod over a national institution.

The portals of Hell finally creaked open this week with confirmation that half of our workforce will be sacked in January as part of health minister Andrew Lansley’s vision of a new slimline National Health Service. The zeal with which our impeding demise is being brought about hasn’t been matched since the sacking of Jerusalem and our glorious leader even managed to lace the bad news with a few jokes.

He reasoned that it was far better to know where we all stood with the minimum of ‘fuss’. And what cheerier way to do so than letting the condemned know by Christmas that we’d be starting 2011 on the dole. I could see a few disgruntled staff weighing up whether or not to throttle him as he appealed for us to remain professional while being cast to the wolves.

The fortunes of workplace departments tend to be cyclic and a new employee can join at any time during the cycle of eternal drudgery.

You could start work with a new influx of fellow staff and be part of a rebirth, which is like the dizzy ascent of a rocket. You could join an established team and flourish under its prosperity or be part of the dying planet that has been plundered of all its resources and is about to implode.

I’ve seen them all come and go a few times but am currently on a dying star that has had the misfortune to drift into the path of a black hole.

The dying star is the NHS and the event horizon is health minister Andrew Lansley who is happily dismantling the organisation into bite sized chunks for the private sector to consume. The Conservatives are nothing if not predictable.

The work place signs are all there. The lack of camaraderie, humour and patience. The aimless empty blustering of senior officers who offer false assurances while planning their own escape and the resignation and listless air of the condemned who plod on because they don’t know what else to do.

GPs have been saying for years that they are best placed to decide how and where money is spent on health care often citing primary care trusts as dictatorial bureaucrats more interested in targets than the needs of the local community.

And so it came to pass that the health fairy Andrew Lansley granted them their wish on one condition.

The caveat is that GPs take full responsibility for how and where money is spent and are held accountable for any failings.

GPs are now wising up to the fact that pretty soon there won’t be a primary care trust to conveniently blame and they will be in the firing line as budget holders.

This realisation, along with the huge skills gap they will have to bridge as GP consortia, has come as something of a shock.

In all likelihood, they will have to re-employ a small army of trust staff to keep things working.

And Andrew Lansley is trying sell us his new vision of the NHS by saying he is cutting bureaucracy. Oh really?

The general public seems blissfully unaware that the Conservative, sorry, Coalition Government is privatising the National Health Service.

Health minister Andrew Lansley has agreed to the abolition of primary care trusts in favour of handing the financial reins to GP consortia by 2013. This train has already left the station.

I’m sure most people aren’t aware that GPs aren’t NHS employees but privately-run businesses that trusts pay to treat local people.

It would be naive to think that clinicians can’t be as self-serving and devisive as anyone else , especially when the Government has said that GPs who perform well will be financially rewarded.

So, we are giving these private businesses billions of pounds of public money to, no doubt, employ other private sector companies at the cost of thousands of NHS jobs and further line their pockets.

I’m not blinkered enough to see that there isn’t huge duplication and wastage in primary care trusts and their top heavy management structures but at least they were impartial and could impose performance targets on GP practices.

Margaret Thatcher must be putting on her glad rags and shaking out the blue rinse bottle at the prospect of David Cameron and Co. finishing off her handiwork. I can feel a 1980s revival coming